Hand osteoarthritis patients characteristics according to the existence ofa hormone replacement therapy

Background: Hand osteoarthritis (hand OA) mostly occurs in women around the time of menopause, but its relationship with sexual hormones remains a con troversial issue. The eventual influence of hormone replacement therapy (HR T) on the incidence and progression of hand OA is still debated. Objective: To assess whether HRT influences the occurrence and disease acti vity of hand OA. Methods/patients: Epidemiological prospective cross-sectional study. Patien ts: Menopausal women, aged 50-75, consulting for painful hand OA, for anoth er rheumatic condition with hand OA or controls (no disease of the upper li mbs). Eligibility criteria: hand OA [American College Rheumatology (ACR) cr iteria] with X-ray evidence. Patients with 'painful' hand OA defined by a D reiser's functional index score greater than or equal to6 and pain on VAS g reater than or equal to 35 mm. Study parameters: Demographics, personal his tories and gynaecologic data for patients and controls including the admini stration of HRT (+) or not (-). For patients, description and symptom activ ity of hand OA. Statistics: Descriptive analysis in the studied population and in subsets taking into account treatment and disease activity factors. Results: 711 women were studied: 238 with 'painful' hand OA, 240 with 'quie scent' and 233 controls. Baseline characteristics were similar for patients and controls except for age (patients were older). HRT+ patients were youn ger (-5 years) (P<0.0001), slightly taller (P<0.0045) and more often cigare ttes smokers (P<0.012) than HRT- patients. They did not differ in gynecolog ic characteristics with the exception that the women in the HRT+ group had been menopausal for a shorter period of time, probably because of their you nger age. There were no differences between HRT+ and HRT- patients, whateve r the symptom activity, on the characteristics of hand OA: Dreiser's index scores were, respectively, 11.3+/-3.8 vs 12.3+/-4.5 in 'painful' patients, 3.6+/-2.5 vs 3.7+/-2.7 in 'quiescent' patients. Pain on VAS showed no diffe rence between the two groups. Conclusion: few differences were found between hand OA patients receiving H RT or not. HRT did not seem to influence the severity or the symptom activi ty of hand OA. Further prospective studies are required in order to evaluat e the exact effect of HRT on hand OA. (C) 2000 OsteoArthritis Research Soci ety International.